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Human Sexuality Chapter 13.docx

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Family Relations and Human Development
FRHD 2100
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Chapter 13: Sexual Dysfunctions 1/22/2012 9:34:00 PM Terms: Sexual dysfunction:  persistent or recurrent difficulties in becoming sexually aroused or reaching orgasm Dyspareunia:  a sexual dysfunction characterized by persistent or recurrent pain during sexual intercourse Vaginismus:  a sexual dysfunction characterized by involuntary contraction of the muscles surrounding the vaginal barrel, preventing penile penetration or rendering penetration painful Vasocongestion:  engorgement of blood vessels with blood, which swells the genitals and breasts during sexual arousal Male erectile disorder:  persistent difficulty getting or maintaining an erection sufficient to allow the man to engage in or complete sexual intercourse. Also termed erectile dysfuction Performance anxiety:  Anxiety concerning ones ability to perform behaviour’s, especially behaviours that may be evaluated by other people Premature ejaculation:  A sexual dysfunction in which ejaculation occurs with minimal sexual stimulation and before the man desires it Anorgasmic:  Never having reaching orgasm Biopsychosocial model:  An approach to explaining dysfunctions that refers to the interactions of biological, phychological, and social/ cultural factors Hypogonadism:  An endocrine disorder that reduces the output of testosterone Tumescence:  Swelling; erection Sex therapy:  A collective term for short-term behavioural models for treatment of sexual dyfunctions Sensale focus exercise’s:  Exercise’s in which sex partners take turns giving and receiving pleasurable stimulation in nongenital areas of the body Squeeze technique:  A method for treating premature ejaculation whereby the tip of the penis is squeezed to prevent ejaculation temporarily Canadian Trends; Sexual Problems in Canada  The best current information we have in Canada is based on the Canadian Contraceptive Survey  Half the woman that participated in a study of sexual difficulties experienced:  low sexual desire (43% experienced diminished sexual desire; 57% of married woman were twice as likely to report low desire as unmarried, 26%)  painful intercourse,  lack of orgasm during intercourse (24% of woman do not have orgasm)  partners erectile difficulties,  and partner’s premature ejaculation.  People with sexual dysfunctions may avoid sexual opportunities for fear of failure o Fear of frustration of physical pain rather than pleasure or gratification due to emphasis that culture places on sexual competence, people feel inadequate or have low self-esteem Types of Sexual Dysfunctions  Sustem of classification of sexual dysfunctions; Diagnostic and statistical manual of mental disorders (dsm) which groups dysfunctions in 4 catagories: o 1. Sexual desire disorder: lack of interst in sex or aversion to sexual contact o 2. Sexual arousal disorders: in men it is difficulty obtaining or sustaining erections sufficient to engage in sex. In women insufficient lubrication o 3. Orgasmic disorders: difficulty reaching orgasm (women) or reach it more quickly then they like (men) o 4. Sexual pain disorders:dyspareunia (painful intercourse); woman may experience vaginismus or involuntary contraction of muscles that surround the vaginal barrel Sexual Desire Disorders: Adversion  Low sexual desire may have little or no interest in sex but are not repelled by genital contact  Some people find it disgusting or aversive and avoid contact  History of erectile problems (men)  History of sexual trauma such as rape or childhood sex abuse often figures cases of sexual adversion Sexual Arousal Disorders o Vasocongestion is unable to be achieved or sustain the lubrication or erection necessary  Male Erectile Disorder: o Persistant difficulty to get an erection long enough to completion of sexual activity o Increases with age and can be common o Can also suffer from performance anxiety from pressure  Female Sexual Arousal Disorder: o Difficulty to become lubricated or sexually excited o Women vary with arousal o Can still have high interest in sex o Diabetes mellitus may lead to diminished sexual arousal or reduced estrogen can cause vaginal dryness Orgasmic Disorders  Female orgasmic disorder: o Difficulty reaching orgasm with adequate amout of sexual stimulation o May be labeled anorgasmic or preorgasmic o May reach orgasm through masturbation  Male Orgasmic Disorder o Delayed ejaculation, retarded ejaculation or ejaculatory incompetence o Many few cases but limited to coitus o May be caused by serious problems such as multiple selerosis or neurological damage  Premature Ejaculation o Ejaculate too rapidly to permit their partners or themselces to enjoy sexual relations fully Sexual Pain Disorders  Dyspareunia o Painful coitus; also includes woman who have persistent pain with attempted vaginal intercourse; more accurate term is vulvodynia o Location of pain can vary; enterance of the vagina, in the vagina or in the pelvic region o Less common in men o May result from physical causes, emotional factors or an interaction of the two o Inadequate lubrication is the most common in woman o STIs or vaginal infection can cause pain o Pain during deep thrusting may be caused bu endometriosis or pelvic inflammatory disease (PID), by other diseases or by structural disorders of the reproductive organs o Psychological factors such as unresolved guilt or anziety about sex or the lingering effects of sexual trauma may also be involved inhibiting lubrication  Vaginismus o Involuntary contraction of the pelvic muscles that surround the outer third of the vaginal barrel o Avoidance of penetration is the key factor differentiating baginismus from dyspareunia o Makes the entery of the penis painful or impossible o Some woman cant take any penetration of any object o Usually from history of sexual trauma, sexual assult or botched abortions o May develop a fear of penetration  Vulvodynia o Gynecological condition characterized by vulval pain particularily chronic burning sensations, irritation and soreness Origins of Sexual Dysfuctions: a biopsychosocial approach  Biological Causes o Selective serotonin reuptake inhibitors (SSRIs) are prescribed not only for depression but also for panic disorder, obsessive- compulsive disorder, anorexia nervosa o These drugs have some sexual side effects in certain patients, and the patient does not always bounce back o Cardiovascular problems in men can lead to an erectile disorder with clogged or narrow arteries leading to the penis deprived of oxygen o Some mens cholesterol can impede the flow of blood to the penis just as it impedes to the heart o Perimenopausal and post women usually produce less baginal lubrication, the walls are thin and can cause painful sex o Weight control and regular exercise for middleaged and older men to prevent clogging of arteries o Nerve damage from prostate surgery may impair erectile response or multiple sclerosis o Syphilis can affect the control of an erection o Woman can develop vascular or nervous disorders that impair genital blood flow reducing lubrication and excitement therefore painful and cannot reach orgasm o Men have erections every 90-100 min in REM sleep o Prescription drugs can be the cause of erectile disorder like antidepressant medication and antipsychotic drugs o Central nervous system depressants like alcohol, heroin and methadone can reduce sexual desire and impair sexual arousal o Narcotics depress testosterone production thereby reducing desire o Weed also has been associated with reduced sexual desire  HIV and Sexual Dysfunctions o HIV/AIDs is associated with sexual dysfunction in both men and women o Men likelyto have hypogonadism and erectile dysfunction which worsened by antiretroviral therapy (increases levels of estrogen in men) o HIV-seropositive women show lack of interest to sexual arousal to problems with orgasms Psychosocial Cause  Changes in sexual desire are more often explained by phychological interpersonal factors such as depression, stress and problems in the relationship  Cultural Influences: o Children in sexually repressive cultural or home environments learn to respond to sex with feelings of anziety and shame o May get a sense of guilt over touching their genitals and may find it hard to accept their sex organs as sources of pleasure o Some cultures some women are reared to believe that sex is a dity to be performed for their hisbands not a source of pleasure o Developed countries view sex as pleasure  Psychosexual Trauma o Women and men who were sexual victums of childgood are more likely to expeience difficulty in becoming sexually aroused  Sexual Orientation o Gays and lesbians test their sexual orientation by developing heterosexual relationships, even by entering “brokeback marriages” in which they rear children with partners of the other sex  Inneffective Sexual Techniques o Couples fall into a narrow sexual routine because one partner controls the timing and sequence of sexual techniques therefore why some males have erectile failure by forcing an erection  Emotional Factors o Orgasm involced a sudden loss of coluntary control; fear of losing control or letting go may block sexual arousal or other emotions like depression  Problems in the Relationship o Partners who have general trouble communicating may also be unable to communicate their sexual desires; those who harbor resentments may make sex their combat arena failing to become aroused by their partners or withhold orgams to make their partners feel guilty or inadequate  Lack of Sexual Skills o Some people may not develop sexual competency because of lack of opportunity to acquire knowledge and experience even within a committed relationship therefore causing dysfunction  Irrational Beliefs o May contribute to sexual dysfuctions o Cannot expect partner to read mind and cannot assume they care for us or know needs/wants therefore communication is key  Performance Anxiety o Occurs when a person becomes overly concered with how well he or she performs a certain act or tast and may place a dyfuntional individual in a spectator role rather than a performer role  Other Factors o Higher body weight associated with low sexual desire and infrequent coital orgams can cause sexual issures and self esteem Treatment of Sexual Dysfunctions  Sex therapy strives for: 1. Change self-defeating beliefs and attitudes 2. teach sexual skills 3. enhance sexual knowledge 4. improve sexual communications 5. reduce performance anxiety  The Masters-and-Johnson Approach o A female-male therpy team focuses on the couple as the unit of treatment during a 2 week residential program o The couple is considered dysfunctional o It may be that the husband has an erectile disorder but this is likely to have led to problems with the couples o The focus is behavioural change; perform daily sexual homework such as sensate focus exercises (done in the nude) in the privacy of their own rooms  Integration of Sex Therapy and Psychotherapy o Many therapists use psychotherapy and couples learn how to share the power in relationships to improve sexual communication and negotiate differences o Enhances relationships and sex lives o Helan Kaplan combined sex therapy and psychotherapy to improve sexual communication, eliminating performance anxiety, and fostering sexual skills and knowledge o Kaplan aimed to bri
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